New cancer drugs held up by the NHS for nine years as rationing body accused of letting down patients

Patients are waiting up to nine years for cancer and Alzheimer’s drugs to be available on the health service because approval takes so long.

The delays mean that even new drugs given the all-clear in extensive trials remain stuck in the queue for years.

A major study found that on average it takes five years from a treatment’s launch by a manufacturer to approval by the rationing body, NICE.

But the process often lasts far longer, and on occasions NICE will not even start its assessment until a drug has been on the market for more than a year.

One of the problems is that NICE – the National Institute for Health and Clinical Excellence – has a wide-ranging remit which includes drawing up NHS guidance on tackling obesity, alcohol abuse and other public health issues.

But last night doctors and charities said it was unfair that patients were being denied potentially life-saving drugs just because the rationing body is bogged down in other tasks.

They said the delays are affecting patients’ quality of life and could make the difference between someone being able to live independently or needing full-time care.

Although patients can get drugs that have not yet been approved by NICE by paying privately or applying to the Cancer Drugs Fund, doctors are often reluctant to prescribe them.

The report by the Office for Health Economics, obtained by GP Newspaper, looked at all the drugs approved by NICE since 2000, covering a total of nearly 300 treatments including those for cancer, Alzheimer’s disease, and heart problems.

When making its decisions, NICE classifies drugs into two groups. Those which would be used on their own undergo ‘single’ appraisals, while those which are taken with another drug are subject to ‘multiple’ appraisals. These take several years longer.

In 2010, the most recent year for which figures are available, the average delay for the 11 drugs which were approved after multiple appraisals was 10.2 years. They included treatments for arthritis, hepatitis C and Crohn’s disease, a debilitating bowel disorder.

The average delay for multiple drugs given the green light in 2005 was 8.7 years. They included treatments for bowel cancer (irinotecan and oxaliplatin) and cancer of the womb (topotecan and pacilitaxel).

In 2006 NICE approved three Alzheimer’s drugs, Aricept, Reminyl and Exelon, although only for patients in the ‘moderate’ stages of the disease.

These treatments would have been classified as multiple appraisals, and that year the average time these assessments had taken was 7.8 years.

Last night Andrew Chidgey of the Alzheimer’s Society said: ‘People with all types of dementia desperately need effective treatments to live a better quality of life and stay independent for longer.

‘Five years is a long time to wait. Whenever a new drug is available, NICE guidance should be issued as quickly as possible.’

Heather Walker of Cancer Research UK said patients needed effective drugs ‘swiftly’ and added: ‘There needs to be a balance between giving NICE enough time to make the right decisions and ensuring that drugs get to patients as soon as possible.’

Dr Anita Sharma, a senior GP in Manchester, said: ‘Being too busy to appraise a drug is not acceptable.’

NICE’s role includes drawing up public health guidelines such as how NHS trusts should tackle obesity. It also sets ‘quality standards’ which state how patients with a range of illnesses should best be treated.

Earlier this year the watchdog took on yet another role and began drawing up guidelines on social care. It will shortly be issuing advice on how NHS staff should care for the elderly with dementia and vulnerable children.

A spokesman from NICE said: ‘We don’t recognise most of the conclusions reached by the Office for Health Economics report which was published in January this year. ‘The report includes in its average figures some drugs that received their licences many years before NICE was established in 1999. ‘NICE has since been asked to appraise such drugs, but their inclusion in this report has skewed the average length of time elapsed from marketing authorisation to published NICE guidance quite considerably.’

Retired paramedic’s £1m payout after bungling surgeons removed wrong part of his brain in operation he didn’t need

A retired paramedic who was left partially blind and needing round-the-clock care after a blunder by surgeons has been awarded more than £1million.

John Tunney, 63, was left severely disabled medical staff mistakenly removed the wrong part of his brain during an operation he didn’t need. Surgeons removed healthy tissue during the operation instead of the tumour which caused a massive brain haemorrhage.

Blood test results – which were not checked before the biopsy – revealed the tumour was benign and could have been treated with tablets.

Mr Tunney, who worked as a paramedic with West Midlands Ambulance Service for 23 years, has been awarded the seven-figure sum from University Hospitals Coventry and Warwickshire NHS Trust after they admitted liability for the blunder. He was awarded a long service award in 2005 and even went back to work part-time two days a week after he retired the same year.

Mr Tunney, from Sutton Coldfield, West Midlands, had a series of tests in 2008 after he suffered suspected thyroid problems.

Doctors at Good Hope Hospital in Sutton Coldfield performed an MRI scan which revealed abnormalities around his pituitary gland and he was referred to a specialist at Walsgrave Hospital in Coventry.

Mr Tunney, had a blood test to determine his hormone levels but doctors failed to check the results.

Mr Tunney, underwent a biopsy on his pituitary gland on April 29, 2008, but suffered brain damage after the surgeon removed normal tissue instead of the tumour.

Mr Tunney’s wife Pamela, 65, said: ‘Our lives have both been completely devastated by a completely avoidable brain injury. ‘It’s something that we have to deal with every single day of our lives. ‘He gets very frustrated at times that he cannot do the things he once took for granted.

‘I remember how we were initially so thankful that this underlying condition had been spotted early.

‘Before the surgery he was a very easy-going, active person who was always on the go. ‘To see the change in him and to know that it was all entirely avoidable is extremely upsetting.

She said the mistakes was ‘not something that the hospital can just take back.’ ‘I pray that they don’t make this sort of error again and no other family has to experience seeing their husband suffer the pain and loss that John has.

‘John was forever praising the work of doctors, so it was only natural for him to put his complete trust in the surgeon after they told him that he needed urgent brain surgery.

‘It is appalling to think the surgeon managed to botch the procedure completely and then to find that the biopsy wasn’t even necessary makes me incredibly angry.’

The family have recently relocated to South Wales along with some friends who help Pamela with John’s constant care.

University Hospitals Coventry and Warwickshire NHS Trust admitted liability and today apologised to the family.

Meghana Pandit, chief medical officer from Walsgrave Hospital said: ‘I would like to apologise on behalf of UHCW again to Mr Tunney and his family for the complications he suffered as a result of his treatment with us four years ago.

‘While we acknowledge that the financial settlement he has now received can never compensate for his suffering, I do hope that our sincere assurances that organisational learning from his management mean that patients with similar conditions will experience high quality and safe care will be reassuring to him.’

Timothy Deeming, a medical law expert with Irwin Mitchell Solicitors in Birmingham, who represented John, said: ‘The fact that the surgeon managed to remove perfectly healthy tissue rather than a sample of the tumour tissue is, in itself, an appalling error. ‘To then find that the procedure was totally unnecessary because clinicians had failed to review a blood test, really does add insult to injury.

‘The failings of the surgeon involved are so serious that the family is calling on the GMC to investigate his actions.’

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About jonjayray

I am former member of the Australia-Soviet Friendship Society, former anarcho-capitalist and former member of the British Conservative party.
The kneejerk response of the Green/Left to people who challenge them is to say that the challenger is in the pay of "Big Oil", "Big Business", "Big Pharma", "Exxon-Mobil", "The Pioneer Fund" or some other entity that they see, in their childish way, as a boogeyman. So I think it might be useful for me to point out that I have NEVER received one cent from anybody by way of support for what I write. As a retired person, I live entirely on my own investments. I do not work for anybody and I am not beholden to anybody

NOTE: I update this blog daily at roughly the same time every day (around midnight, Eastern Australian time or 2pm GMT) so if there are no recent posts long after the usual time for them to go up, it will almost certainly be due to one of the service interruptions that Wordpress (hosts of this blog) sometimes undergoes. In that case, however, all is not lost, as I will put up mirror sites of the blog if I become aware of the service outage. Go to either here or here to find another copy of what should be up on this blog. Note however that I no longer update the mirror sites daily. Service outages are as far as I am aware now too rare to justify that

Postings from Brisbane, Australia by John Ray (M.A.; Ph.D.) -- former member of the Australia-Soviet Friendship Society, former anarcho-capitalist and former member of the British Conservative party.

As a socialist organization, it is no surprise that the NHS comes second only to the Nazis and Communists as a mass murderer. They have a truly Hitlerian contempt for "useless eaters". That the "useless eater" they are condemning to death might be your beloved mother or grandmother cuts no ice with them.
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Some TERMINOLOGY for non-British readers: The British "A Level" exam is roughly equivalent to a U.S. High School diploma. Rather confusingly, you can get As, Bs or Cs in your "A Level" results. Entrance to the better universities normally requires several As in your "A Levels".

The BIGGEST confusion in British terminology, however, surrounds use of the term "public school". Traditionally, a public school was where people who were rich but not rich enough to afford private tutors sent their kids. So a British public school is a fee-paying school. It is what Americans or Australians would call a private school. Brits are however aware of the confusion this causes benighted non-Brits so these days often in the media use "Independent" where once they would have used "public". The term for a taxpayer-supported school in Britain is a State school, but there are several varieties of those. The most common (and deplorable) type of State school is a "Comprehensive"

Again for American readers: A "pensioner" is a retired person living on Social Security

Consensus. Margaret Thatcher in a 1981 speech: "For me, pragmatism is not enough. Nor is that fashionable word "consensus."... To me consensus seems to be the process of abandoning all beliefs, principles, values and policies in search of something in which no one believes, but to which no one objects—the process of avoiding the very issues that have to be solved, merely because you cannot get agreement on the way ahead. What great cause would have been fought and won under the banner "I stand for consensus"?

For my sins I have always loved G.B. Shaw's witty comment: "No Englishman can open his mouth without causing another Englishman to despise him". But Shaw was Irish, of course.

Britain has enormous claims to fame -- most of which the 1997 to 2010 Labour government did its best to destroy. But one glory no-one can destroy is British humour. And if you don't "get" British humour, your life is a dreary desert indeed. A superb sample here

Here is a link to my favourite British political speech since WWII. It is by Nigel Farage, the Leader of the UK Independence Party. He is referring to the Fascistic decision by the EU parliament to act as if their huge new "constitution" had been approved by the voters when in fact majorities in France, Ireland and Nederland (Holland) have rejected it at the ballot box. He points out that abuse is all they have to offer when he points out the impropriety of their actions.

Farage's expression, "A complete shower" is British slang meaning a group of completely incompetent and useless failures. It originated in the British armed forces where its unabbreviated version was "A complete shower of sh*t".

Britain appears to be the first country where anti-patriotism gained strong hold. Even Friedrich Engels (the co-worker with Karl Marx who died in 1895) was a furious German patriot. Much of the British elite were anti-patriotic from the early 20th century onwards, however. The "Cambridge spies" (from one of Britain's two most prestigious universities) are a good example of that. Although Cambridge appears to have been the chief nest of spies-to-be in Britain of the 30s, however, Oxford was also very Leftist. In 1933 (9th Feb.) the Oxford Union debated the motion: "This House will in no circumstances fight for King and Country". The motion was overwhelmingly carried (275 to 153).

I have an abiding fascination with the Church of England. It is the sort of fascination one might have for a once-distinguished elderly relative who has gone bad and become a slave to the bottle. But nothing I can say about the C of E (which these days seems to stand for The Church of the Environment) could surpass what the whole of English literature says of it -- which ranges from seeing it as a collection of nincompoops and incompetents to seeing it as comprised of evil hypocrites. Yet its 39 "Articles of Religion" of 1562 are an abiding and eloquent statement of Protestant faith. But I guess that 1562 is a long time ago.

The intellectual Roman Emperor Marcus Aurelius (AD 121-180) could well have been thinking of modern Britain when he said: "The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane."

On all my blogs, I express my view of what is important primarily by the readings that I select for posting. I do however on occasions add personal comments in italicized form at the beginning of an article.

I am rather pleased to report that I am a lifelong conservative. Out of intellectual curiosity, I did in my youth join organizations from right across the political spectrum so I am certainly not closed-minded and am very familiar with the full spectrum of political thinking. Nonetheless, I did not have to undergo the lurch from Left to Right that so many people undergo. At age 13 I used my pocket-money to subscribe to the "Reader's Digest" -- the main conservative organ available in small town Australia of the 1950s. I have learnt much since but am pleased and amused to note that history has since confirmed most of what I thought at that early age.

I imagine that the RD are still sending mailouts to my 1950s address

The kneejerk response of the Green/Left to people who challenge them is to say that the challenger is in the pay of "Big Oil", "Big Business", "Big Pharma", "Exxon-Mobil", "The Pioneer Fund" or some other entity that they see, in their childish way, as a boogeyman. So I think it might be useful for me to point out that I have NEVER received one cent from anybody by way of support for what I write. As a retired person, I live entirely on my own investments. I do not work for anybody and I am not beholden to anybody. And I have NO investments in oil companies, mining companies or "Big Pharma"

UPDATE: Despite my (statistical) aversion to mining stocks, I have recently bought a few shares in BHP -- the world's biggest miner, I gather. I run the grave risk of becoming a speaker of famous last words for saying this but I suspect that BHP is now so big as to be largely immune from the risks that plague most mining companies. I also know of no issue affecting BHP where my writings would have any relevance. The Left seem to have a visceral hatred of miners. I have never quite figured out why.

I am an army man. Although my service in the Australian army was chiefly noted for its un-notability, I DID join voluntarily in the Vietnam era, I DID reach the rank of Sergeant, and I DID volunteer for a posting in Vietnam. So I think I may be forgiven for saying something that most army men think but which most don't say because they think it is too obvious: The profession of arms is the noblest profession of all because it is the only profession where you offer to lay down your life in performing your duties. Our men fought so that people could say and think what they like but I myself always treat military men with great respect -- respect which in my view is simply their due.

Although I have been an atheist for all my adult life, I have no hesitation in saying that the single book which has influenced me most is the New Testament. And my Scripture blog will show that I know whereof I speak.

Many people hunger and thirst after righteousness. Some find it in the hatreds of the Left. Others find it in the love of Christ. I don't hunger and thirst after righteousness at all. I hunger and thirst after truth. How old-fashioned can you get?

My academic background

My full name is Dr. John Joseph RAY. I am a former university teacher aged 65 at the time of writing in 2009. I was born of Australian pioneer stock in 1943 at Innisfail in the State of Queensland in Australia. I trace my ancestry wholly to the British Isles. After an early education at Innisfail State Rural School and Cairns State High School, I taught myself for matriculation. I took my B.A. in Psychology from the University of Queensland in Brisbane. I then moved to Sydney (in New South Wales, Australia) and took my M.A. in psychology from the University of Sydney in 1969 and my Ph.D. from the School of Behavioural Sciences at Macquarie University in 1974. I first tutored in psychology at Macquarie University and then taught sociology at the University of NSW. My doctorate is in psychology but I taught mainly sociology in my 14 years as a university teacher. In High Schools I taught economics. I have taught in both traditional and "progressive" (low discipline) High Schools. Fuller biographical notes here